Abstract

The study aimed to examine age- and sex-specific associations between health literacy (HL) and healthy lifestyle characteristics. The cross-sectional study was conducted to examine a total 1348 Japanese participants (613 male and 735 female) who took the health check-up program in April 2013, at Tsumagoi Village, Japan. Information was collected by self-administered questionnaire on three communicative and two critical HL items, and healthy lifestyle characteristics listed in Bres-low’s seven health practices. In multivariate logistic analysis, high HL (≥18) was significantly asso-ciated with healthy lifestyle characteristics in both non-elderly (<65 years old) and elderly (≥65 years old) [Odds ratio (OR) = 1.40, 95% Confidence interval (CI) = 1.13 - 1.75 for non-elderly, OR = 1.34, 95% CI = 1.02 - 1.76 for elderly], as well as female participants (OR = 1.43, 95% CI = 1.06 - 1.94), while the significance was borderline in male participants (OR = 1.34, 95% CI = 0.96 - 1.88). Among 5 HL items, the ability to extract health-related information was significantly associated with healthy lifestyle characteristics (OR = 1.52, 95% CI = 1.11 - 2.07 for non-elderly, OR = 1.55, 95% CI = 1.04 - 2.30 for elderly, OR = 1.95, 95% CI = 1.28 - 2.97 for female participants. HDL-C concentration in the high HL group was significantly higher than that in the low HL group. Among healthy lifestyle characteristics, proportions of smoking behavior (non-smoker), exercise frequency (twice or more per week), and sleep duration (7 - 8 hours) were significantly higher in the high HL group than in the low HL group. The present study revealed a positive association between HL and healthy lifestyle characteristics, which suggests that people are likely to engage in health-promoting behaviours based on access and ability to understand medical information for both age groups and female participants. Significant findings among female participants may be emphasized since it’s important from the entire family's perspective as women are the caretakers of the family. These findings may indicate the importance of comprehensive assessment, including HL, for health promotion in the community.

Highlights

  • In recent decades, developed as well as developing countries have faced a dramatic increase in the number of adults suffering from non-communicable diseases (NCDs) such as diabetes, cardiovascular disease (CVD), and chronic kidney disease (CKD) [1]

  • The present study revealed a positive association between health literacy (HL) and healthy lifestyle characteristics, which suggests that people are likely to engage in health-promoting behaviours based on access and ability to understand medical information for both age groups and female participants

  • The results show that high HL was significantly associated with having 6 - 7 healthy lifestyle characteristics in Model 1 among non-elderly (Odds ratio [OR] = 1.40, 95% Confidence interval [CI] = 1.13 1.75) (Table 2(a)) and elderly (OR = 1.34, 95% CI = 1.02 - 1.76) participants (Table 2(b))

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Summary

Introduction

In recent decades, developed as well as developing countries have faced a dramatic increase in the number of adults suffering from non-communicable diseases (NCDs) such as diabetes, cardiovascular disease (CVD), and chronic kidney disease (CKD) [1]. Adequate use of these resources depends on an individual’s skill in finding and applying information about their health issues [6]. These skills have been conceptualized as health literacy (HL). Individuals with adequate HL are considered likely to adopt healthy lifestyles [8], and a brief questionnaire was developed to assess HL [9]. Only a few studies have estimated the association between HL and healthy lifestyle characteristics among Japanese people and reports that broadly include women and the elderly in rural communities are especially limited [9] [10]

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